The Limits of Reductionism in Medicine: Could Systems Biology Offer an Alternative?

In the first of a two part series, Ahn and colleagues discuss the reductionist approach pervading medicine and explain how a systems approach (as advocated by systems biology) may complement reductionism

Factors and common conditions associated with adolescent dietary supplement use: an analysis of the National Health and Nutrition Examination Survey (NHANES)

<p>Abstract</p> <p>Background</p> <p>Little is known about the prevalence of dietary supplement (DS) use in American adolescents. We conducted this study to analyze the prevalence of DS use and factors associated with this use in a national population-based sample.</p> <p>Methods</p> <p>We used data from the 1999 – 2002 National Health and Nutrition Examination Surveys (NHANES) for adolescents age 11 to 19. Using weighted logistic regression, we identified demographic and clinical factors associated with the use of any DS, vitamins or minerals, herbs and other DS.</p> <p>Results</p> <p>Among the 5,306 responses representing approximately 36 million Americans 11–19 years old, 27% reported use of one or more DS in the prior month. The most commonly used DS were: multivitamins (16%) and vitamin C (6%). In the multivariable analysis, African American [adjusted odds ratio 0.40 (0.31–0.50) 95% CI] and Mexican American [0.55 (0.44–0.69)] adolescents were less likely to use DS compared with non-Hispanic whites. DS use was more common in those who used prescription medications [1.37 (1.10–1.72)] and among those who had a diagnosis of chronic headaches [1.25 (1.04–1.50)]. DS use was less common among those reporting fair or poor health status [0.59 (0.40–0.88)].</p> <p>Conclusion</p> <p>Twenty seven percent of American adolescents use DS. DS use is higher among teens that use prescription medications; physicians and pharmacists should be aware of this, ask patients, and check for potential interactions.</p

Factors associated with dietary supplement use among prescription medication users

BACKGROUND: We examined the patterns of nonvitamin dietary supplement (NVDS) use among adult prescription medication users in the United States. METHODS: Using the 2002 National Health Interview Survey, we analyzed factors associated with NVDS use and prescription medication use in the prior 12 months with descriptive, chi(2), and logistic regression analysis. RESULTS: In the United States, 21% of adult prescription medication users reported using NVDSs in the prior 12 months. Of the respondents who used both prescription medications and NVDSs in the prior 12 months, 69% did not discuss this use with a conventional medical practitioner. Among adults who used prescription medications in the prior 12 months, the most commonly used supplements included echinacea, ginseng, ginkgo, garlic, and glucosamine chondroitin. Prescription medication users with menopause and chronic gastrointestinal disorders had the highest rates of NVDS use (33% and 28%, respectively), and prescription medication users with coronary heart disease and history of myocardial infarction had the lowest rates of use (12% each). In the adjusted analysis, factors associated with increased use of NVDSs by prescription medication users included being female, being Hispanic, having more years of education, living in the West, lacking medical insurance, and having chronic conditions. Elderly respondents were less likely to use NVDSs. CONCLUSION: One in 4 prescription medication users took an NVDS in the prior 12 months, yet the majority did not share this with a conventional medical professional

Academic Library and Publisher Collaboration: Utilizing an Institutional Repository to Maximize the Visibility and Impact of Articles by University Authors

The George A. Smathers Libraries (Libraries) (http://www.uflib.ufl.edu/) at the University of Florida (UF) (http://www.ufl.edu/) and Elsevier (http://www.elsevier.com) have embarked on a pilot project to maximize visibility, impact, and dissemination of articles by UF researchers who have published in Elsevier journals. Article links and metadata are automatically delivered to UF’s Institutional Repository, the IR@UF (http://ufdc.ufl.edu/ir), in the IR@UF-Elsevier Collection (http://ufdc.ufl.edu/ielsevier). The metadata, with links for approximately 31,000 articles by UF authors, is made possible through integration of the IR@UF with the ScienceDirect application programming interfaces (APIs) (https://www.elsevier.com/solutions/sciencedirect/support/institutional-repository) that are freely available to libraries. Access to the full text on ScienceDirect is available for all institutional repository users affiliated with a subscribing institution. In the next phase users without subscriptions will be able to access the manuscripts of articles published from 2013 forward. This will be done by embedding metadata and links to accepted manuscripts available on ScienceDirect into the IR@UF. We will conduct user and usability testing of this cross-platform user experience. This article provides an overview of the project’s current status, how it works, what it delivers, and next steps expanding the project to include articles by UF authors from other publishers. It concludes with strategic considerations, future developments, and reflections on the value of library/publisher collaboration

A medical student elective promoting humanism, communication skills, complementary and alternative medicine and physician self-care: an evaluation of the HEART program.

ObjectiveIn 2002 the American Medical Student Association (AMSA) created a fourth-year medical student elective known as the Humanistic Elective in alternative medicine, Activism, and Reflective Transformation (HEART) that provided the opportunity for students to explore humanism in medicine, self-care, complementary and alternative medicine modalities, communication, activism, and community building in a four-week immersion experience. The educational effects of this elective, and whether it has met its stated goals, are unknown.MethodThe authors conducted a web-based, cross-sectional survey of the first eight cohorts of HEART graduates in 2010. Survey questions assessed respondents' demographics and perspectives on the educational impact of the elective. Descriptive statistics were used to characterize the sample and qualitative analyses were guided by grounded theory.ResultsOf 168 eligible alumni, 122 (73%) completed the survey. The majority were female (70%), age ≤35 (77%) years, and trained in primary care specialties (66%). Half were attendings in practice. The majority of respondents felt the elective taught professionalism (89%) and communication skills (92%) well or very well. The majority highly agreed that the elective helped them better cope with stress during residency training (80%), taught them self-care skills (75%), and improved their ability to empathize and connect with patients (71%). Qualitative analysis of the personal and professional impact of the elective identified twelve common themes with self-discovery, self-care, and collegial development/community most frequently cited.ConclusionsThe majority of HEART graduates endorse learning important skills and benefiting from the experience both personally and professionally. Aspects of the HEART curriculum may help training programs teach professionalism and improve trainee well-being

Impact of The Daily Mile on children's physical and mental health, and educational attainment in primary schools: iMprOVE cohort study protocol.

Funder: Cancer Research UKFunder: British Heart FoundationIntroductionSchool-based active mile initiatives such as The Daily Mile (TDM) are widely promoted to address shortfalls in meeting physical activity recommendations. The iMprOVE Study aims to examine the impact of TDM on children's physical and mental health and educational attainment throughout primary school. METHODS AND ANALYSIS: iMprOVE is a longitudinal quasi-experimental cohort study. We will send a survey to all state-funded primary schools in Greater London to identify participation in TDM. The survey responses will be used for non-random allocation to either the intervention group (Daily Mile schools) or to the control group (non-Daily Mile schools). We aim to recruit 3533 year 1 children (aged 5-6 years) from 77 primary schools and follow them up annually until the end of their primary school years. Data collection taking place at baseline (children in school year 1) and each primary school year thereafter includes device-based measures of moderate-to-vigorous physical activity (MVPA) and questionnaires to measure mental health (Strengths and Difficulties Questionnaire) and educational attainment (ratings from 'below expected' to 'above expected levels'). The primary outcome is the mean change in MVPA minutes from baseline to year 6 during the school day among the intervention group compared with controls. We will use multilevel linear regression models adjusting for sociodemographic data and participation in TDM. The study is powered to detect a 10% (5.5 min) difference between the intervention and control group which would be considered clinically significant.Ethics and disseminationEthics has been approved from Imperial College Research Ethics Committee, reference 20IC6127. Key findings will be disseminated to the public through research networks, social, print and media broadcasts, community engagement opportunities and schools. We will work with policy-makers for direct application and impact of our findings

Impact of The Daily Mile on children's physical and mental health, and educational attainment in primary schools: iMprOVE cohort study protocol.

Funder: Cancer Research UKFunder: British Heart FoundationIntroductionSchool-based active mile initiatives such as The Daily Mile (TDM) are widely promoted to address shortfalls in meeting physical activity recommendations. The iMprOVE Study aims to examine the impact of TDM on children's physical and mental health and educational attainment throughout primary school. METHODS AND ANALYSIS: iMprOVE is a longitudinal quasi-experimental cohort study. We will send a survey to all state-funded primary schools in Greater London to identify participation in TDM. The survey responses will be used for non-random allocation to either the intervention group (Daily Mile schools) or to the control group (non-Daily Mile schools). We aim to recruit 3533 year 1 children (aged 5-6 years) from 77 primary schools and follow them up annually until the end of their primary school years. Data collection taking place at baseline (children in school year 1) and each primary school year thereafter includes device-based measures of moderate-to-vigorous physical activity (MVPA) and questionnaires to measure mental health (Strengths and Difficulties Questionnaire) and educational attainment (ratings from 'below expected' to 'above expected levels'). The primary outcome is the mean change in MVPA minutes from baseline to year 6 during the school day among the intervention group compared with controls. We will use multilevel linear regression models adjusting for sociodemographic data and participation in TDM. The study is powered to detect a 10% (5.5 min) difference between the intervention and control group which would be considered clinically significant.Ethics and disseminationEthics has been approved from Imperial College Research Ethics Committee, reference 20IC6127. Key findings will be disseminated to the public through research networks, social, print and media broadcasts, community engagement opportunities and schools. We will work with policy-makers for direct application and impact of our findings

Hand Preference for Coordinated Bimanual Actions in 777 Great Apes: Implications for the Evolution of Handedness in Hominins

Whether or not nonhuman primates exhibit population-level handedness remains a topic of considerable scientific debate. Here, we examined handedness for coordinated bimanual actions in a sample of 777 great apes including chimpanzees, bonobos, gorillas, and orangutans. We found population-level right-handedness in chimpanzees, bonobos and gorillas, but left-handedness in orangutans. Directional biases in handedness were consistent across independent samples of apes within each genus. We suggest that, contrary to previous claims, population-level handedness is evident in great apes but differs among species as a result of ecological adaptations associated with posture and locomotion. We further suggest that historical views of nonhuman primate handedness have been too anthropocentric, and we advocate for a larger evolutionary framework for the consideration of handedness and other aspects of hemispheric specialization among primates

Inelastic light, neutron, and X-ray scatterings related to the heterogeneous elasticity of glasses

The effects of plasticization of poly(methyl methacrylate) glass on the boson peaks observed by Raman and neutron scattering are compared. In plasticized glass the cohesion heterogeneities are responsible for the neutron boson peak and partially for the Raman one, which is enhanced by the composition heterogeneities. Because the composition heterogeneities have a size similar to that of the cohesion ones and form quasiperiodic clusters, as observed by small angle X-ray scattering, it is inferred that the cohesion heterogeneities in a normal glass form nearly periodic arrangements too. Such structure at the nanometric scale explains the linear dispersion of the vibrational frequency versus the transfer momentum observed by inelastic X-ray scattering.Comment: 9 pages, 2 figures, to be published in J. Non-Cryst. Solids (Proceedings of the 4th IDMRCS